Discusión entre pares / 45 yrs M Pts has closed shaft humerus # with complete transected Radial Nerve

Indian-Orthopaedic Research-Group

Parag Raiyani

Ayer a las 2:40

45 yrs M Pts has closed shaft humerus # with complete transected Radial Nerve . Platting done . What should be done now ?? Radial nerve repair or Tendon transfer . Kindlly give your expert opinions.

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  Ashwini Sood Radial nerve repair.should have been done at the time of plating !

  Ayer a las 2:47 · Me gusta · 3
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  Parag Raiyani Sir what about results of repair ?? Hows yr experience ??

  Ayer a las 2:50 · Me gusta
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  Anoop R. Nair Have no second thoughts ...its always primary nerve repair always in any major nerve transection injury and wait for recovery for 6-9 months ..then depending on deficits do tendon transfer.

  Ayer a las 3:00 · Me gusta · 4
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  P.s. Balaji Primary stands good chance

  Ayer a las 3:11 · Me gusta
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  Ashish Agarwal sorry dear.u should ask this before opening.

  Ayer a las 3:27 · Me gusta · 5
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  Jaya Krishna Singh Radial nerve repair at the time of plating...

  Ayer a las 4:15 · Me gusta
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  Rajasekhar Rao P radial nerve repair is not encouraging but even if few muscles are re innervated we can take less tendons for future transfer

  Ayer a las 4:30 · Me gusta
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  Ashwini Sood Radial nerve being pure motor nerve ( nearly ) has the best chance of recovery in upper limb unlike ulnar and median which r mixed nerves.

  Ayer a las 4:32 · Me gusta · 3
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  Rajasekhar Rao P http://www.ncbi.nlm.nih.gov/pubmed/11476297

  

  The radial and posterior interosseous n... [J Bone Joint Surg Br. 2001] - PubMed - NCBI

  www.ncbi.nlm.nih.gov

  PubMed comprises more than 23 million citations for biomedical literature from M...Ver más

  Ayer a las 4:35 · Me gusta
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  Ramesh Kumar Gupta Repair s\b done at the time of plating

  Ayer a las 4:37 · Me gusta
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  Rajasekhar Rao P yes u do plating and do repair if you are not expert doing in repair just keep it end to end so that there wont be retraction and call plastic surgeon for next time or same day

  Ayer a las 4:38 · Me gusta · 4
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  Vikas Saxena If you found transected radial nerve during surgery, it would have been primarily prepared then only always. There is good chance of recovery as it is pure motor nerve. By the way how much time has elapsed since then?

  Ayer a las 4:46 · Me gusta · 1
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  Kulvinder Gill Repair at time of plating.

  Ayer a las 5:17 · Me gusta
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  Parag Raiyani 1 day.

  Ayer a las 5:18 · Me gusta
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  Parag Raiyani Thanks all of you .

  Ayer a las 5:19 · Me gusta
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  DrDilawar Khan Mahsud Rad nerve Repair during the surgery

  Ayer a las 5:27 · Me gusta
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  Ashwini Sood Just a thought !
  # being closed and also at mid shaft is quite unlikely to cause complete transection of radial nerve. I hope it is not iatrogenic ! !

  Ayer a las 6:24 · Me gusta · 2
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  Sai Prasad Radial nerve repair has good chances of recovery

  Ayer a las 7:30 · Me gusta
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  Sai Prasad I had a similar case 
  Mode of injury was,pt arm was hit by a branch of a tree, while he was riding on a bike 
  Orif was done and repair of the nerve was done by a plastic surgeon 
  We had lot of difficulty in finding the prox.end as it got retracted higher up in the arm, which shows the severity of trauma 
  Pt is improving, 4months post op follow up

  Ayer a las 7:39 · Me gusta · 1
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  Parag Raiyani This is not iatrogenic we could not find prox end . Its retracted

  Ayer a las 8:13 · Me gusta
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  Parag Raiyani Dr Ashwini Sood sir.... u might have come across that kind of iatrogenic injuries because in this patient all extensor muscles were damaged. .. and sir if it is iatrogenic than we could have been able to find proximal end of it easily sir....

  Ayer a las 8:22 · Me gusta
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  Arvind Verma Jangid i did similar case repaired radial; nerve at same time

  Ayer a las 8:36 · Me gusta
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  Shyamlal Mukhi Radial nerve repair

  Ayer a las 8:48 · Me gusta
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  Ashwini Sood please try to take it as a discussion.u were not able to repair the radial nerve because you could not find the proximal end ? If you had already diagnosed radial nerve injury pre-op then may be yu could have opted for posterior approach .

  Ayer a las 9:16 · Me gusta · 1
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  Shamim Bhat What was indication of or if??. Is plating answer to it...

  Ayer a las 9:40 · Me gusta
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  Parag Raiyani I know pre op but no one can know that nerve could be transacted completely. Ok sir now what is best repair or tendon transfer ??

  Ayer a las 9:55 · Me gusta
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  Parag Raiyani One of plastic surgeon advised me to do repair but prognosis cant predict

  Ayer a las 9:56 · Me gusta
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  Kulvinder Gill If radial nerve injury best approach is posterior .

  Ayer a las 10:24 · Me gusta
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  Shyamlal Mukhi Still the best treatment is repair do not give up

  Ayer a las 10:33 · Me gusta
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  Parag Raiyani Ya we do it through post approach .. planning for Radian Nerve Repair

  Ayer a las 12:55 · Me gusta
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  Arvind Verma Jangid intraop

  

  Ayer a las 12:58 · Me gusta
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  Arvind Verma Jangid repaired radial nerve

  

  Ayer a las 12:59 · Me gusta · 1
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  Shrikrishna Dhone certainly repair first...afterwords depending on recovery with cockup splint

  Ayer a las 13:15 · Me gusta
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  Nishikant Kumar Repair + Internal splinting with transfer of PT to ECRB.

  Ayer a las 13:23 · Me gusta · 2
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  Avinash Kumar yes........... absolutely repair which is better being almost truly motor nerve and then burkhalter's internal splinting..........and remember PT to ECRB is end to side not end to end.

  Ayer a las 13:25 · Me gusta
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  Avinash Kumar BOTH IN SAME SITTING

  Ayer a las 13:26 · Me gusta
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  Ashit Mehta I had a similar case with RNP in closed fr shaft humerus middle third.
  I went postly never anticipating cut nerve as its not usual to get cut nerve at middle third shaft humerus. Found cut retracted nerve on table. Haf to call plastic surgron frd of mine who did primary repair. 
  I think incidence is much more than literature mentions because we dont document it. I did not do it and m sure all who had such cases here would not have documented it.

  Hace 21 horas · Me gusta
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  Vishal Garg nerve repair:: radial nerve recovers well

  Hace 19 horas · Me gusta
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  Indian-Orthopaedic Research-Group Steve Rocha Sir, please opine

  Hace 18 horas · Me gusta
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  Nisarg Raninga Bhuro Sir I had a similar case # shaft humerus with primary rnp, I hv opened from post RN was intact do plating, 2 months had gone no recovery yet, started oral steroid and methycobal but still no result, now wt to do?